Health-based risk neutralization in private disability insurance

Elisabeth C Wijnvoord, Jan Buitenhuis, Sandra Brouwer, Jac J L van der Klink, Michiel R de Boer

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

BACKGROUND: Exclusions are used by insurers to neutralize higher than average risks of sickness absence (SA). However, differentiating risk groups according to one's medical situation can be seen as discrimination against people with health problems in violation of a 2006 United Nations convention. The objective of this study is to investigate whether the risk of SA of insured persons with exclusions added to their insurance contract differs from the risk of persons without exclusions.

METHODS: A dynamic cohort of 15 632 applicants for private disability insurance at a company insuring only college and university educated self-employed in the Netherlands. Mean follow-up was 8.94 years. Duration and number of SA periods were derived from insurance data to calculate the hazard of SA periods and of recurrence of SA periods.

RESULTS: Self-employed with an exclusion added to their insurance policy experienced a higher hazard of one or more periods of SA and on average more SA days than self-employed without an exclusion.

CONCLUSION: Persons with an exclusion had a higher risk of SA than persons without an exclusion. The question to what extent an individual should benefit from being less vulnerable to disease and SA must be addressed in a larger societal context, taking other aspects of health inequality and solidarity into account as well.

Original languageEnglish
Pages (from-to)1045-1049
Number of pages5
JournalEuropean Journal of Public Health
Volume26
Issue number6
DOIs
Publication statusPublished - Dec 2016

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Disability Insurance
Insurance
Health
Insurance Carriers
United Nations
Contracts
Netherlands
Recurrence

Keywords

  • Journal Article

Cite this

Wijnvoord, Elisabeth C ; Buitenhuis, Jan ; Brouwer, Sandra ; van der Klink, Jac J L ; de Boer, Michiel R. / Health-based risk neutralization in private disability insurance. In: European Journal of Public Health. 2016 ; Vol. 26, No. 6. pp. 1045-1049.
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title = "Health-based risk neutralization in private disability insurance",
abstract = "BACKGROUND: Exclusions are used by insurers to neutralize higher than average risks of sickness absence (SA). However, differentiating risk groups according to one's medical situation can be seen as discrimination against people with health problems in violation of a 2006 United Nations convention. The objective of this study is to investigate whether the risk of SA of insured persons with exclusions added to their insurance contract differs from the risk of persons without exclusions.METHODS: A dynamic cohort of 15 632 applicants for private disability insurance at a company insuring only college and university educated self-employed in the Netherlands. Mean follow-up was 8.94 years. Duration and number of SA periods were derived from insurance data to calculate the hazard of SA periods and of recurrence of SA periods.RESULTS: Self-employed with an exclusion added to their insurance policy experienced a higher hazard of one or more periods of SA and on average more SA days than self-employed without an exclusion.CONCLUSION: Persons with an exclusion had a higher risk of SA than persons without an exclusion. The question to what extent an individual should benefit from being less vulnerable to disease and SA must be addressed in a larger societal context, taking other aspects of health inequality and solidarity into account as well.",
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Wijnvoord, EC, Buitenhuis, J, Brouwer, S, van der Klink, JJL & de Boer, MR 2016, 'Health-based risk neutralization in private disability insurance' European Journal of Public Health, vol. 26, no. 6, pp. 1045-1049. https://doi.org/10.1093/eurpub/ckw079

Health-based risk neutralization in private disability insurance. / Wijnvoord, Elisabeth C; Buitenhuis, Jan; Brouwer, Sandra; van der Klink, Jac J L; de Boer, Michiel R.

In: European Journal of Public Health, Vol. 26, No. 6, 12.2016, p. 1045-1049.

Research output: Contribution to JournalArticleAcademicpeer-review

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T1 - Health-based risk neutralization in private disability insurance

AU - Wijnvoord, Elisabeth C

AU - Buitenhuis, Jan

AU - Brouwer, Sandra

AU - van der Klink, Jac J L

AU - de Boer, Michiel R

N1 - © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association.

PY - 2016/12

Y1 - 2016/12

N2 - BACKGROUND: Exclusions are used by insurers to neutralize higher than average risks of sickness absence (SA). However, differentiating risk groups according to one's medical situation can be seen as discrimination against people with health problems in violation of a 2006 United Nations convention. The objective of this study is to investigate whether the risk of SA of insured persons with exclusions added to their insurance contract differs from the risk of persons without exclusions.METHODS: A dynamic cohort of 15 632 applicants for private disability insurance at a company insuring only college and university educated self-employed in the Netherlands. Mean follow-up was 8.94 years. Duration and number of SA periods were derived from insurance data to calculate the hazard of SA periods and of recurrence of SA periods.RESULTS: Self-employed with an exclusion added to their insurance policy experienced a higher hazard of one or more periods of SA and on average more SA days than self-employed without an exclusion.CONCLUSION: Persons with an exclusion had a higher risk of SA than persons without an exclusion. The question to what extent an individual should benefit from being less vulnerable to disease and SA must be addressed in a larger societal context, taking other aspects of health inequality and solidarity into account as well.

AB - BACKGROUND: Exclusions are used by insurers to neutralize higher than average risks of sickness absence (SA). However, differentiating risk groups according to one's medical situation can be seen as discrimination against people with health problems in violation of a 2006 United Nations convention. The objective of this study is to investigate whether the risk of SA of insured persons with exclusions added to their insurance contract differs from the risk of persons without exclusions.METHODS: A dynamic cohort of 15 632 applicants for private disability insurance at a company insuring only college and university educated self-employed in the Netherlands. Mean follow-up was 8.94 years. Duration and number of SA periods were derived from insurance data to calculate the hazard of SA periods and of recurrence of SA periods.RESULTS: Self-employed with an exclusion added to their insurance policy experienced a higher hazard of one or more periods of SA and on average more SA days than self-employed without an exclusion.CONCLUSION: Persons with an exclusion had a higher risk of SA than persons without an exclusion. The question to what extent an individual should benefit from being less vulnerable to disease and SA must be addressed in a larger societal context, taking other aspects of health inequality and solidarity into account as well.

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